1. Field of the Invention
The present invention relates to endoscopic surgery and, more particularly, to devices and methods for use in endoscopic surgery to absorb body fluids, manipulate or retract tissue or organ structures, separate adhering tissue (lysis of adhesion), and/or pack the endoscopic surgical site to isolate tissue to be treated, protect surrounding tissue and increase visibility for the surgeon.
2. Description of the Prior Art
Endoscopically performed operative procedures are preferred for surgery on the human body due to their least invasive nature and reduced trauma and tissue damage as compared with open surgery. While endoscopically performed operative procedures are preferred, there are and have been obstacles to expanding endoscopy to include the various procedures currently performed with open surgery. For example, prior to applicant's U.S. patent applications Ser. Nos. 07/556,081, now U.S. Pat. No. 5,074,840, 07/600,775 and 07/789,599, the specifications of which are incorporated herein by reference, packing of the internal operative site could not be accomplished. Without packing, endoscopic procedures are much more difficult and dangerous to perform since the tissue or organ structure can not be adequately exposed and manipulated, the surrounding tissue and organ structure is not protected during the procedure and body fluids cannot be removed from the operative site without the use of expensive and cumbersome suction equipment. Furthermore, electrosurgical or laser instruments as commonly used in endoscopic procedures for coagulation and cutting present the opportunity for accidental contact or scarring of tissue not intended to be treated if the operative site is not adequately packed to expose and isolate the tissue to be treated and if vision is impaired by blood or other body fluids. Accordingly, great care is required when utilizing laser and electrosurgical probes to assure that adjacent tissue is not inadvertently damaged thusly increasing the time required to complete the surgery. Additionally, in most endoscopic procedures, there is very little space at the operative site in which to introduce and maneuver instruments such that facilitating procedures including, for example, tissue retraction and manipulation, cleaning and wiping of tissue, lysis of adhesion and irrigation and/or aspiration, cannot be achieved.
Applicant's patent applications referenced above disclose multifunctional devices for being introduced at an internal operative site, such as an operative site within an anatomical cavity, through a narrow portal, such as a natural or incisional opening or a portal sleeve, to perform or facilitate various procedures including, for example, manipulation or retraction of tissue or organ structure, irrigation, absorption of body fluids, separation of adhering tissue and/or packing of an endoscopic operative site to isolate tissue to be treated, protect surrounding tissue and increase visibility for the surgeon. It is desirable in many procedures, such as cystic cavity coagulation, endometrial ablation and uterine manipulation, for example, in which the multifunctional devices are utilized for the devices to have a relatively large external size or surface area for increased exposure to tissue. Accordingly, there is a need to allow the external size or surface area of the multifunctional devices to be selectively increased during use to enhance various procedures and, in particular, to increase the external size or surface area of multifunctional devices utilizing an absorbent material while minimizing the quantity of absorbent material required. There is also a need to facilitate reducing or decreasing the external size or surface area of the multifunctional devices to facilitate withdrawal of the devices through the portal.